title: Statin therapy in patients with atypical chest pain and mild-to-moderate coronary stenosis on 64-slice multidetector coronary computed tomography; a retrospective propensity score matching analysis.
abstract: BACKGROUND
  The effect of computed tomography (CT)-guided statin therapy on patients with atypical chest pain and mild-to-moderate coronary artery disease has not been elucidated yet.
  
  
  METHODS
  A total of 1,952 patients who had 1-69 % stenosis on CT were reviewed retrospectively. After propensity score matching, 643 patients who were prescribed statins after CT (statin users) and 643 patients without statin therapy (statin non-users) were compared. Major cardiovascular events included all-cause death, acute coronary syndrome and stroke.
  
  
  RESULTS
  During a median of 42 months' follow-up, all-cause death was reported in 17 patients (1.3 %), of whom 6 (0.9 %) were statin users and 11 (1.7 %) statin nonusers. Major cardiovascular events developed in 6.1 % in the statin user group and 5.6 % in the statin non-users (P = 0.812). When evaluated according to plaque subtypes, statins showed significant benefit in patients who had non-calcified or mixed plaque (HR 0.47, 95 % CI 0.22-1.01, P = 0.047). However, in patients with calcified plaques, statins had no benefit in reducing adverse events (P = 0.620).
  
  
  CONCLUSIONS
  In most patients with mild-to-moderate coronary artery stenosis on CT, statin therapy has no beneficial effect on reducing adverse events. However, in patients with non-calcified or mixed plaques, statin therapy showed a significant benefit.
  
  
  CONCLUSIONS
  • Multidetector CT now identifies numerous subjects with mild-to-moderate coronary stenosis. • Statin therapy has little beneficial effect on patients with calcified plaques. • However, statins reduce adverse events in those with non-calcified or mixed plaques.
authors.affiliation: Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Hyo Eun
authors.initials: HE
authors.lastname: Park
authors.forename: Goo-Yeong
authors.initials: GY
authors.lastname: Cho
authors.forename: Yeonyee E
authors.initials: YE
authors.lastname: Yoon
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Youn
authors.forename: Eun-Ju
authors.initials: EJ
authors.lastname: Chun
authors.forename: Sang-Il
authors.initials: SI
authors.lastname: Choi
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
mesh_terms: D002637:Chest Pain / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D057216:Propensity Score; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors